Until 1977, coronary revascularization was only possible using open surgical techniques. Approximately 10 years after the introduction of coronary angioplasty, a series of major clinical trials comparing the outcome of patients treated by surgery and angioplasty were planned and executed. The results of these trials are now becoming available and show that in patients with symptomatic disease affecting one, two, or three vessels, angioplasty is a viable alternative to surgery. From a purely medical point of view, the advantages and disadvantages of the two techniques are so finely balanced that patients preference has become an important parameter in selection of a primary intervention.